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Male lower urinary tract symptoms and α 1 D ‐adrenoceptors
Author(s) -
Ishizuka Osamu,
Imamura Tetsuya,
Kurizaki Yoshiki,
Nishizawa Osamu,
Andersson KarlErik
Publication year - 2013
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2012.03223.x
Subject(s) - medicine , urinary system , lower urinary tract symptoms , urology , adrenergic receptor , endocrinology , receptor , prostate , cancer
Historically, α 1 ‐adrenoceptors have been classified into three subtypes (α 1 A , α 1 B and α 1 D ) that are widely distributed in various organs. Research on the α 1 D ‐adrenoceptors in the bladder, urethra and prostate has focused on the relationship between expression levels and symptoms of bladder outlet obstruction, and the implications and functional roles of α 1 D ‐adrenoceptors subtypes in these organs. The α 1 D ‐adrenoceptor messenger ribonucleic acid and protein seem to be increased in obstructed bladders or small capacity bladders. In contrast, α 1 D ‐adrenoceptor subtype knock‐out mice have been found to have a prolonged voiding interval. Interestingly, an α 1 D ‐adrenoceptor antagonist was found to inhibit the facilitation of afferent nerve activity for the micturition reflex induced by intravesical infusion of acetic acid. Clinically, patients who felt urgency at low filling volumes and had a small bladder capacity were found to have more α 1 D ‐adrenoceptor messenger ribonucleic acid in their bladder mucosa than patients who felt urgency at high filling volumes and had a large bladder capacity. An α 1 D ‐adrenoceptor antagonist was found to increase the first desired volume and the maximum desired volume while decreasing detrusor overactivity in pressure flow studies. Thus, α 1 D ‐adrenoceptors in the lower urinary tract might play an important role in the pathophysiology of lower urinary tract disorders.